| NPI | 1932432424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 38167) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 13117) |
| 1223G0001X Dentist, General Practice (Licence: MD 13117) | |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2022-05-13 |